What question did this study set out to answer?

This research aims to determine the impact of dedicated IBD-antenatal clinics on pregnancy and neonatal outcomes in patients with active inflammatory bowel disease.

January 23, 2026

DOP042Dedicated Joint Inflammatory Bowel Disease-Antenatal clinics are associated with better pregnancy and neonatal outcomes in patients with active Inflammatory Bowel Disease during pregnancy: results from a large UK multi-centre cohort

Key Points

This research aims to determine the impact of dedicated IBD-antenatal clinics on pregnancy and neonatal outcomes in patients with active inflammatory bowel disease.
Conducted a multi-centre retrospective cohort study across 16 UK sites.
Included pregnant patients with active IBD, defined by specific clinical symptoms and laboratory markers.
Utilized logistic regression and multivariate analyses adjusted for maternal factors to assess outcomes.
Included 399 pregnancies; 23.1% experienced adverse IBD outcomes, mainly hospitalizations.
33.3% faced adverse pregnancy or neonatal outcomes, with persistent active disease as a key factor.
Management in a joint IBD-antenatal clinic reduced adverse outcomes, showing a significant protective effect (RRR 0.40).

Abstract

Abstract Background Active inflammatory bowel disease (IBD) during pregnancy is associated with an increased risk of adverse outcomes. Identifying predictors can inform targeted interventions. Methods A multi-centre retrospective cohort study was conducted across 16 UK sites, 8 of which offered a joint IBD-antenatal clinic. Pregnant patients with active IBD defined by clinical symptoms and/or elevated FCP (≥250 μg/g) or CRP (≥5 mg/L) - and either (i) change in IBD therapy (ii) IBD-related hospitalisation or (iii) IBD related surgery were included. Composite endpoints were: a. Adverse IBD outcome; IBD related hospitalisation or luminal surgery during pregnancy. b. Adverse pregnancy or neonatal outcome; 1 of spontaneous pregnancy loss, small-for-gestational-age infant, fetal growth restriction, low birth weight (2500g), preterm birth (37 weeks gestation), maternal or neonatal infection requiring antibiotics, APGAR score 7 at 5 minutes, NICU admission, or congenital defect. Logistic regression and multivariate analyses adjusted for maternal age, BMI, and smoking status at conception, to determine a relative risk ratio (RRR). Results Three hundred and ninety-nine pregnancies were included. Active disease was predominantly detected in the second trimester (55.4%) with a median (IQR) CRP of 9 (5-20) mg/L and FCP 600(438-1350) μg/g. Adverse IBD outcomes occurred in 23.1% (n = 92) with 91 patients having an IBD related hospitalisation and 6 patients undergoing luminal surgery in pregnancy. Predictors included prior bowel resection (RRR 3.78, 95% CI 1.59–9.0; p = 0.003), prior exposure to ≥ 3 biologics (RRR 3.91, 95% CI 1.47–10.35; p = 0.006), moderate–severe disease at pre-conception (RRR 2.98, 95% CI 1.24–7.12; p = 0.014) or at flare onset (RRR 2.94, 95% CI 1.04–8.27; p = 0.041). Initiation of corticosteroids (RRR 7.24, 95% CI 3.85–13.62; p 0.0005) or biologics (RRR 2.85, 95% CI 1.45–5.61; p = 0.002) during pregnancy were also associated with adverse IBD outcomes. An Adverse pregnancy or neonatal outcome occurred in 33.3% (n = 133), associated with persistence of active disease post-induction of definitive therapy (RRR 1.29, 95% CI 1.04-5.30; p = 0.039) and emergency caesarean section (RRR 3.13, 95% CI 1.56–6.26; p = 0.001). Management in a joint IBD-antenatal clinic was protective (RRR 0.40, 95% CI 0.22–0.72; p = 0.002), with a lower rate of adverse PAN outcomes compared to single speciality clinics (29.4% vs 50.7%, p 0.001). Conclusion This study highlights a high-risk cohort requiring personalised pre-conception counselling and enhanced monitoring in pregnancy. Care within a dedicated IBD-antenatal clinic was associated with a lower rate of adverse outcomes, supporting embedding of this multidisciplinary model as standard of care for management of IBD in pregnancy. Conflict of interest: Shah, Krishna: No conflict of interest Dalrymple, Kathryn: No conflict of interest Rellou, Sofia: No conflict of interest Selinger, Christian Philipp: No conflict of interest Yeo, Jie Han: No conflict of interest Maxfield, Dominic: No conflict of interest Limdi, Jimmy: No conflict of interest Johnston, Emma: Nil Kefayat, Amirhosein: No conflict of interest Thoua, Nora: No conflict of interest Thakor, Amit: No conflict of interest Kent, Alexandra: I have received honoraria/Consultancy/Sponsorship fees from: Lilly, AbbVie, Coloplast, J & J, Pfizer, Takeda, Tillotts, Dr Falk, Galapagos/AlfaSigma Hicks, Lucy: No conflict of interest Cooney, Rachel: No conflict of interest Sebastian, Shaji: Grant: Takeda, Tillots pharma, Biogen, Pfizer, Abbvie, Johnson & Johnson, Olympus -Odin Vision Personal Fees: Tillots, Johnson & Johnson, Olympus Odin Vision, AbbVie, Takeda, Merck, Pharmacosmos, Amgen, Eli Lilly, BMS, Odin Vision Non-financial Support: Tillots, Takeda, AbbVie, Celltrion, Johnson & Johnson, Eli Lilly, Alphasigma, Ferring Pharma Braddy-Green, Cameron: No conflict of interest Gordon, Hannah: Personal Fees: Speaker fees : Janssen (J & J), Ferring, Takeda, AbbVie, Lilly Consultancy fees: AbbVie, Galapagos, Janssen (J & J), Takeda, Lilly Jawad, Noor: No conflict of interest Kaler, Mandeep Kaur: No conflict of interest Parkes, Gareth: No conflict of interest Lindsay, James O: No conflict of interest Kok, Klaartje: Speaker or advisory fees or support for attending conferences from Abbvie, Janssen, Takeda, Galapagos, Lilly, Falk.

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